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Dietary diversity no longer offsets the mortality risk of hyperhomocysteinaemia in older adults with diabetes: a prospective cohort study

背景與目的:飲食品質可能減輕糖尿病患因高同半胱氨酸血症增加的死亡風險。方法與研究設計:1999 - 2000年臺灣老人營養健康狀況調查形成這個前瞻世代。基線健康狀況、飲食和體位測量被記錄,血漿同半胱氨酸和B群維生素生物標記被測量。非糖尿病的參與者(n=985)當作那些已經有糖尿病或至2006年期間發生糖尿病者(n=427)之參考組,評估參與者於1999-2008年間同半胱氨酸對死亡風險的影響。結果:男性、吸菸者和那些身體生理功能較差者,有較高的同半胱氨酸,但糖尿病患者並非如此。糖尿病發生率與同半胱氨酸無關。在高同半胱氨酸寫症患者中(≥15 vs <15 mol/ L),患有糖尿病者,其調整後之... Full description

Journal Title: Asia Pacific Journal of Clinical Nutrition / 亞太地區臨床營養期刊 2016-06-01, 25卷2期 (Vol.25, Issue 2), pp.414-423
Main Author: Mark L Wahlqvist
Other Authors: Lili Xiu , Meei-Shyuan Lee , Rosalind Chia-Yu Chen , Kuan-Ju Chen , Duo Li
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: DOI: 10.6133/apjcn.112015.06 ; Publication DOI: 10.6133/apjcn ; ISSN: 0964-7058
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recordid: airitilib09647058-201606-201605310001-201605310001-414-423
title: Dietary diversity no longer offsets the mortality risk of hyperhomocysteinaemia in older adults with diabetes: a prospective cohort study
format: Article
creator:
  • Mark L Wahlqvist
  • Lili Xiu
  • Meei-Shyuan Lee
  • Rosalind Chia-Yu Chen
  • Kuan-Ju Chen
  • Duo Li
subjects:
  • 同半胱氨酸
  • 2型糖尿病患者
  • 老年人
  • 死亡率
  • 飲食多樣性
  • Homocysteine
  • Type 2 Diabetes
  • Elderly
  • Mortality
  • Dietary Diversity
ispartof: Asia Pacific Journal of Clinical Nutrition / 亞太地區臨床營養期刊, 2016-06-01, 25卷2期 (Vol.25, Issue 2), pp.414-423
description: 背景與目的:飲食品質可能減輕糖尿病患因高同半胱氨酸血症增加的死亡風險。方法與研究設計:1999 - 2000年臺灣老人營養健康狀況調查形成這個前瞻世代。基線健康狀況、飲食和體位測量被記錄,血漿同半胱氨酸和B群維生素生物標記被測量。非糖尿病的參與者(n=985)當作那些已經有糖尿病或至2006年期間發生糖尿病者(n=427)之參考組,評估參與者於1999-2008年間同半胱氨酸對死亡風險的影響。結果:男性、吸菸者和那些身體生理功能較差者,有較高的同半胱氨酸,但糖尿病患者並非如此。糖尿病發生率與同半胱氨酸無關。在高同半胱氨酸寫症患者中(≥15 vs <15 mol/ L),患有糖尿病者,其調整後之死亡危害比(HR)及95%信賴區間為1.71(1.18-2.46);同半胱氨酸與糖尿病之間的交互作用p值0.005。非糖尿病患者,以有較高的飲食多樣性得分(DDS >4)及較低的同半胱氨酸血症者為參考組,高同半胱氨酸血症者加上較低的DDS(≤4)的聯合死亡風險更大HR為1.80(1.27-2.54)及顯著的交互作用(p=0.008);相較之下,對糖尿病並無聯合作用。儘管有高同半胱氨酸血症的參與者其血漿葉酸濃度較低,DDS減輕同半胱氨酸血症對死亡的貢獻並無法被維生素B群所解釋。心臟衰竭是高同半胱氨酸血症參與者的主要死因。結論:在非糖尿病的高同半胱氨酸血症患者,無論維生素B群的狀況,較多樣化的飲食可以增加存活率。但是,對高同半胱氨酸血症的糖尿病患者,其心肌病變對飲食的反應可能較差。
language: eng
source:
identifier: DOI: 10.6133/apjcn.112015.06 ; Publication DOI: 10.6133/apjcn ; ISSN: 0964-7058
fulltext: fulltext
issn:
  • 09647058
  • 0964-7058
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titleDietary diversity no longer offsets the mortality risk of hyperhomocysteinaemia in older adults with diabetes: a prospective cohort study
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ispartofAsia Pacific Journal of Clinical Nutrition / 亞太地區臨床營養期刊, 2016-06-01, 25卷2期 (Vol.25, Issue 2), pp.414-423
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subject同半胱氨酸 ; 2型糖尿病患者 ; 老年人 ; 死亡率 ; 飲食多樣性 ; Homocysteine ; Type 2 Diabetes ; Elderly ; Mortality ; Dietary Diversity
description
0背景與目的:飲食品質可能減輕糖尿病患因高同半胱氨酸血症增加的死亡風險。方法與研究設計:1999 - 2000年臺灣老人營養健康狀況調查形成這個前瞻世代。基線健康狀況、飲食和體位測量被記錄,血漿同半胱氨酸和B群維生素生物標記被測量。非糖尿病的參與者(n=985)當作那些已經有糖尿病或至2006年期間發生糖尿病者(n=427)之參考組,評估參與者於1999-2008年間同半胱氨酸對死亡風險的影響。結果:男性、吸菸者和那些身體生理功能較差者,有較高的同半胱氨酸,但糖尿病患者並非如此。糖尿病發生率與同半胱氨酸無關。在高同半胱氨酸寫症患者中(≥15 vs <15 mol/ L),患有糖尿病者,其調整後之死亡危害比(HR)及95%信賴區間為1.71(1.18-2.46);同半胱氨酸與糖尿病之間的交互作用p值0.005。非糖尿病患者,以有較高的飲食多樣性得分(DDS >4)及較低的同半胱氨酸血症者為參考組,高同半胱氨酸血症者加上較低的DDS(≤4)的聯合死亡風險更大HR為1.80(1.27-2.54)及顯著的交互作用(p=0.008);相較之下,對糖尿病並無聯合作用。儘管有高同半胱氨酸血症的參與者其血漿葉酸濃度較低,DDS減輕同半胱氨酸血症對死亡的貢獻並無法被維生素B群所解釋。心臟衰竭是高同半胱氨酸血症參與者的主要死因。結論:在非糖尿病的高同半胱氨酸血症患者,無論維生素B群的狀況,較多樣化的飲食可以增加存活率。但是,對高同半胱氨酸血症的糖尿病患者,其心肌病變對飲食的反應可能較差。
1Background and Objective: The increased mortality risk of hyperhomocysteinaemia in diabetes may be mitigated by dietary quality. Methods and Study Design: The Nutrition and Health Survey in Taiwan of 1999-2000 for elders formed this prospective cohort. Baseline health status, diet and anthropometry were documented and plasma homocysteine and biomarkers for B vitamins measured. Participants without diabetes (n=985) were referent for those who had diabetes or developed diabetes until 2006 (n=427). The effect of homocysteine on mortality risk during 1999-2008 was evaluated. Results: Men, smokers and those with poorer physical function had higher homocysteine, but less so with diabetes. Diabetes incidence was unrelated to homocysteine. In hyperhomocysteinaemia (≥15 vs <15 μmol/L), those with diabetes had an adjusted hazard ratio (HR) (95% CI) for mortality of 1.71 (1.18-2.46); p for interaction between homocysteine and diabetes was 0.005. Without diabetes, but with hyperhomocysteinaemia and a low dietary diversity score (DDS ≤4 of 6), where the joint mortality hazard for the greater DDS, (>4) and lower homocysteine (<15) was referent, the HR was 1.80 (1.27-2.54) with significant interaction (p=0.008); by contrast, there was no joint effect with diabetes. The contribution of DDS to mortality mitigation in hyperhomocysteinaemia could not be explained by B group vitamins, even though plasma folate was low in hyperhomocysteinaemic participants. With hyperhomocysteinaemia, heart failure was a major cause of death. Conclusions: In non-diabetic hyperhomocysteinaemia, a more diverse diet increases survival prospects independent of B group vitamins, but not in hyperhomocysteinaemic diabetes where the cardiomyopathy may be less responsive.
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1Lili Xiu
2Meei-Shyuan Lee
3Rosalind Chia-Yu Chen
4Kuan-Ju Chen
5Duo Li
titleDietary diversity no longer offsets the mortality risk of hyperhomocysteinaemia in older adults with diabetes: a prospective cohort study
description
0背景與目的:飲食品質可能減輕糖尿病患因高同半胱氨酸血症增加的死亡風險。方法與研究設計:1999 - 2000年臺灣老人營養健康狀況調查形成這個前瞻世代。基線健康狀況、飲食和體位測量被記錄,血漿同半胱氨酸和B群維生素生物標記被測量。非糖尿病的參與者(n=985)當作那些已經有糖尿病或至2006年期間發生糖尿病者(n=427)之參考組,評估參與者於1999-2008年間同半胱氨酸對死亡風險的影響。結果:男性、吸菸者和那些身體生理功能較差者,有較高的同半胱氨酸,但糖尿病患者並非如此。糖尿病發生率與同半胱氨酸無關。在高同半胱氨酸寫症患者中(≥15 vs <15 mol/ L),患有糖尿病者,其調整後之死亡危害比(HR)及95%信賴區間為1.71(1.18-2.46);同半胱氨酸與糖尿病之間的交互作用p值0.005。非糖尿病患者,以有較高的飲食多樣性得分(DDS >4)及較低的同半胱氨酸血症者為參考組,高同半胱氨酸血症者加上較低的DDS(≤4)的聯合死亡風險更大HR為1.80(1.27-2.54)及顯著的交互作用(p=0.008);相較之下,對糖尿病並無聯合作用。儘管有高同半胱氨酸血症的參與者其血漿葉酸濃度較低,DDS減輕同半胱氨酸血症對死亡的貢獻並無法被維生素B群所解釋。心臟衰竭是高同半胱氨酸血症參與者的主要死因。結論:在非糖尿病的高同半胱氨酸血症患者,無論維生素B群的狀況,較多樣化的飲食可以增加存活率。但是,對高同半胱氨酸血症的糖尿病患者,其心肌病變對飲食的反應可能較差。
1Background and Objective: The increased mortality risk of hyperhomocysteinaemia in diabetes may be mitigated by dietary quality. Methods and Study Design: The Nutrition and Health Survey in Taiwan of 1999-2000 for elders formed this prospective cohort. Baseline health status, diet and anthropometry were documented and plasma homocysteine and biomarkers for B vitamins measured. Participants without diabetes (n=985) were referent for those who had diabetes or developed diabetes until 2006 (n=427). The effect of homocysteine on mortality risk during 1999-2008 was evaluated. Results: Men, smokers and those with poorer physical function had higher homocysteine, but less so with diabetes. Diabetes incidence was unrelated to homocysteine. In hyperhomocysteinaemia (≥15 vs <15 μmol/L), those with diabetes had an adjusted hazard ratio (HR) (95% CI) for mortality of 1.71 (1.18-2.46); p for interaction between homocysteine and diabetes was 0.005. Without diabetes, but with hyperhomocysteinaemia and a low dietary diversity score (DDS ≤4 of 6), where the joint mortality hazard for the greater DDS, (>4) and lower homocysteine (<15) was referent, the HR was 1.80 (1.27-2.54) with significant interaction (p=0.008); by contrast, there was no joint effect with diabetes. The contribution of DDS to mortality mitigation in hyperhomocysteinaemia could not be explained by B group vitamins, even though plasma folate was low in hyperhomocysteinaemic participants. With hyperhomocysteinaemia, heart failure was a major cause of death. Conclusions: In non-diabetic hyperhomocysteinaemia, a more diverse diet increases survival prospects independent of B group vitamins, but not in hyperhomocysteinaemic diabetes where the cardiomyopathy may be less responsive.
subject
0同半胱氨酸
12型糖尿病患者
2老年人
3死亡率
4飲食多樣性
5Homocysteine
6Type 2 Diabetes
7Elderly
8Mortality
9Dietary Diversity
general
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1中文電子期刊服務 - Chinese Electronic Periodical Services (CEPS) (Airiti Library)
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310.6133/apjcn
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50964-7058
625卷2期
7Dietary diversity no longer offsets the mortality risk of hyperhomocysteinaemia in older adults with diabetes: a prospective cohort study
8The aims of the Asia Pacific Journal of Clinical Nutrition (APJCN) are to publish high quality clinical nutrition relevant research findings which can build the capacity of clinical nutritionists in the region and enhance the practice of human nutrition and related disciplines for health promotion and disease prevention.
920190613>與單位確認刊頻為季刊(3,6,9,12),以前是累積的檔案太多,才會一年出6期(雙月刊1,3,5,7,9,11)
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0飲食多樣性無法抵銷高同半胱氨酸血症老年糖尿病患者的死亡風險:一個前瞻性世代研究
1Ya T'Ai Ti Ch'U Lin Ch'Uang Ying Yang Ch'I K'An
2Ya Tai Di Qu Lin Chuang Ying Yang Qi Kan
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titleDietary diversity no longer offsets the mortality risk of hyperhomocysteinaemia in older adults with diabetes: a prospective cohort study
authorMark L Wahlqvist ; Lili Xiu ; Meei-Shyuan Lee ; Rosalind Chia-Yu Chen ; Kuan-Ju Chen ; Duo Li
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4飲食多樣性
5Homocysteine
6Type 2 Diabetes
7Elderly
8Mortality
9Dietary Diversity
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abstract背景與目的:飲食品質可能減輕糖尿病患因高同半胱氨酸血症增加的死亡風險。方法與研究設計:1999 - 2000年臺灣老人營養健康狀況調查形成這個前瞻世代。基線健康狀況、飲食和體位測量被記錄,血漿同半胱氨酸和B群維生素生物標記被測量。非糖尿病的參與者(n=985)當作那些已經有糖尿病或至2006年期間發生糖尿病者(n=427)之參考組,評估參與者於1999-2008年間同半胱氨酸對死亡風險的影響。結果:男性、吸菸者和那些身體生理功能較差者,有較高的同半胱氨酸,但糖尿病患者並非如此。糖尿病發生率與同半胱氨酸無關。在高同半胱氨酸寫症患者中(≥15 vs <15 mol/ L),患有糖尿病者,其調整後之死亡危害比(HR)及95%信賴區間為1.71(1.18-2.46);同半胱氨酸與糖尿病之間的交互作用p值0.005。非糖尿病患者,以有較高的飲食多樣性得分(DDS >4)及較低的同半胱氨酸血症者為參考組,高同半胱氨酸血症者加上較低的DDS(≤4)的聯合死亡風險更大HR為1.80(1.27-2.54)及顯著的交互作用(p=0.008);相較之下,對糖尿病並無聯合作用。儘管有高同半胱氨酸血症的參與者其血漿葉酸濃度較低,DDS減輕同半胱氨酸血症對死亡的貢獻並無法被維生素B群所解釋。心臟衰竭是高同半胱氨酸血症參與者的主要死因。結論:在非糖尿病的高同半胱氨酸血症患者,無論維生素B群的狀況,較多樣化的飲食可以增加存活率。但是,對高同半胱氨酸血症的糖尿病患者,其心肌病變對飲食的反應可能較差。 ; Background and Objective: The increased mortality risk of hyperhomocysteinaemia in diabetes may be mitigated by dietary quality. Methods and Study Design: The Nutrition and Health Survey in Taiwan of 1999-2000 for elders formed this prospective cohort. Baseline health status, diet and anthropometry were documented and plasma homocysteine and biomarkers for B vitamins measured. Participants without diabetes (n=985) were referent for those who had diabetes or developed diabetes until 2006 (n=427). The effect of homocysteine on mortality risk during 1999-2008 was evaluated. Results: Men, smokers and those with poorer physical function had higher homocysteine, but less so with diabetes. Diabetes incidence was unrelated to homocysteine. In hyperhomocysteinaemia (≥15 vs <15 μmol/L), those with diabetes had an adjusted hazard ratio (HR) (95% CI) for mortality of 1.71 (1.18-2.46); p for interaction between homocysteine and diabetes was 0.005. Without diabetes, but with hyperhomocysteinaemia and a low dietary diversity score (DDS ≤4 of 6), where the joint mortality hazard for the greater DDS, (>4) and lower homocysteine (<15) was referent, the HR was 1.80 (1.27-2.54) with significant interaction (p=0.008); by contrast, there was no joint effect with diabetes. The contribution of DDS to mortality mitigation in hyperhomocysteinaemia could not be explained by B group vitamins, even though plasma folate was low in hyperhomocysteinaemic participants. With hyperhomocysteinaemia, heart failure was a major cause of death. Conclusions: In non-diabetic hyperhomocysteinaemia, a more diverse diet increases survival prospects independent of B group vitamins, but not in hyperhomocysteinaemic diabetes where the cardiomyopathy may be less responsive.
pubHEC Press
doi10.6133/apjcn.112015.06
tpages10
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